Health care update: let’s kill this bill, drive a stake through its heart, encase it in cement and bury it at the bottom of the ocean

(Just in case there was any doubt where I stand.)

The bill that the Congressional Budget Office has already estimated would uninsure 24 million Americans over the next ten years got even worse today, when the Fake President agreed to allow insurance companies to sell fake insurance.

This was one of the key demands of the House “Freedom Caucus,” for whom uninsuring 24 million Americans in order to give a tax break to individuals earning more than $200,000 a year is not enough. They also want to give insurance companies the freedom to sell insurance that covers, basically, nothing. This morning, ace negotiator Donald Trump acceded to that demand.

For cancer survivors like me – and for anyone else with significant medical needs, or a significant likelihood of developing significant medical needs – this is a disaster.

Eliminating the requirement that all insurance policies cover essential health benefits would allow insurance companies to drop such frivolous benefits as maternity care or chemotherapy. The stated rationale: individuals shouldn’t be forced to pay for coverage they don’t want.

Let’s pause here for a second to let that sink in.


And now let’s think about the purpose of insurance: to pool costs across a broad population so that individuals are not left to bear them alone. In the case of health care, that applies to both bad stuff (even though, very fortunately, the bad stuff won’t happen to most people in any given year, though it will almost certainly happen to all of us eventually) and good stuff (like having a baby) and routine, preventive maintenance stuff.

“I can’t have babies,” the stylized complaint goes (and even though, thanks to chemo and the passage of time, that statement applies to me, I always imagine it being harrumphed by a portly, gray-haired man), “so why should my health insurance cover maternity care?”

Um . . . maybe because if only women of childbearing age who plan to have kids opt for insurance that does cover maternity care, that coverage will either  (a) be outrageously expensive or (b) disappear from the market.

And on it goes. Chemotherapy: sure, those of us who won the cancer lottery care a lot about this, but others don’t. Drop it. Substance abuse treatment: forget about it.

Really, dropping the essential benefits requirement is a backdoor way of reintroducing the despicable practice of denying coverage to people with preexisting conditions or bad health histories, and jacking up rates for women of childbearing age.

Oh, and if you don’t think this applies to you (“this sure sucks for people who have to buy policies through the individual market, thank God I have coverage through my employer”), think again. The essential benefits provision of health care reform was one of the aspects of the law that applied to group coverage as well as the Obamacare exchanges.

. . .  

As gratifying as it is to learn that this monstrosity of a health care bill is falling short in the House (I’m personally enjoying the mental image of Paul Ryan, 4:01:25 marathon runner, sweating as he races from office to office to twist arms), it’s not dead yet. Keep those calls, letters, rallies, and general hell-raising going. It worked for Staten Island/Bay Ridge Representative Dan Donovan, who came out against the bill yesterday after extensive grassroots pressure from his district.

We can kill this thing.


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